The incidence of umbilical cord encirclement in twins in this study was 10.1%. Twins with tight cord entanglement (TCE) had a 1-minute Apgar score predominantly at the range of 0-6, (3 of 4), unlike those with loose cord entanglement (LCE) whose Apgar scores at 1 minute occurred evenly in the 0-6 (15 of 29) and 7-10 (14 of 29) score range. The perinatal mortality rate was significantly higher for tight cord-entangled twins (750 per 1,000) compared to noncord-entangled (NCE) (58 per 1,000) and all twins (61 per 1,000). All the perinatal deaths occurred in the tight cord-entangled (TCE) twins, 2 of the 3 being in second twins with gestational age less than 30 weeks. The umbilical cord was significantly longer in cord-entangled twins compared to all twins (p < 0.0005) by 11.7 cm for twin 1 and 10.4 cm for twin 2. No difference occurred in birth-weight between cord-entangled twins 1 and 2 and between them and non-cord entangled twins. There was no difference in the overall mode of delivery for the cord entangled, nonentangled and all twins, although cord entanglement was more prevalent in spontaneous vertex vaginal deliveries compared to other modes of delivery for the first twin only.